Gestational diabetes: The basics

November is National Diabetes Month, so we are talking about gestational diabetes, a type of diabetes that some women develop during pregnancy.

Let’s address some of the basics.

First, what is diabetes?Diabetes means the body has a problem with insulin. Insulin is a hormone that helps the body use sugar from the blood for energy. When you have diabetes, your body either does not make enough insulin or does not use insulin as well as it should. Glucose (sugar) builds up in the blood because the body cannot use sugar without the help of insulin. This causes blood sugar to stay high with damaging effects to the body.

What is gestational diabetes? Gestational diabetes means that the body has a problem with insulin during pregnancy. When women are pregnant, the body needs more insulin to keep blood sugar at the right level, so women’s bodies produce more insulin. When the extra insulin is not enough to keep blood sugar normal, women get high blood sugar. This is called gestational diabetes. Blood sugar usually returns to normal after delivery.

Am I at risk? About 7 out of 100 pregnant women get gestational diabetes.

Gestational diabetes is more likely in:

Women who are overweight.

Women with family members who have had gestational diabetes.

Women with family members who have type 2 diabetes.

African American, American Indian, and Hispanic/Latina American women.

Women who delivered another baby that was “macrosomic” ( > 4,000g)

Women with polycystic ovarian syndrome (PCOS)

Women on medications for other conditions that affect glucose metabolism (e.g. steroids)

Women carrying more than one baby (e.g. twins, triplets)

How do I know if I have gestational diabetes?Gestational diabetes usually is diagnosed at the end of the second trimester. Most of the time, doctors and midwives test for it in the 5th or 6th month of pregnancy. Early screening for gestational diabetes should be considered if a woman has had gestational diabetes in a prior pregnancy, if she is obese, has a family history of diabetes, if she has polycystic ovarian syndrome, if she is noted to have a lot of sugar in her urine. Women are tested by drinking a special sugary drink ( a glucose challenge test) and having their blood sugar checked an hour after drinking it.

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About The Author

Dr. de Veciana has an international background and is multilingual. She is currently an Associate Professor in the Division of Maternal-Fetal Medicine of the Dept of OB/GYN of Eastern Virginia Medical School. She mentors Endocrine and Maternal-Fetal Medicine fellows and OB/GYN residents in training and has a passion for teaching. She directs the Diabetes in Pregnancy Program at EVMS, which is nationally and internationally recognized for state of the art management of DM in pregnancy. She is a member of the American Diabetes Association Diabetes in Pregnancy Council and the Diabetes Council of the Society of Maternal-Fetal Medicine. She is an active Board member on the Hampton Roads chapter of the Juvenile Diabetes Research Foundation. Dr. de Veciana, is well published and is internationally known for her research supporting the value of post-prandial glucose monitoring in pregnant diabetics. On a personal note, she grew up with a sister with Type 1 and a dad with Type 2 DM which taught her more than any textbook ever could.